AB0390 COST-EFFECTIVENESS OF IGURATIMOD IN PATIENTS WITH RHEUMATOID ARTHRITIS (RA) BY USING A CLAIMS-BASED ALGORITHM: RETROSPECTIVE ANALYSIS OF REAL‑WORLD DATA
Authors: Y. Wang, T. Shi, J. Deng, J. Wu, Y. Qu, Y. Zhang, X. Zhu, B. Liang, Q. Yu, H. Du, L. Jie
Journal: Annals of the Rheumatic Diseases (2022)

Background Iguratimod (IGU), as one of the conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), has been approved by National Medical Products Administration (NMPA) to treat Rheumatoid arthritis (RA). Objectives This study aimed to compare the cost-effectiveness of well-established RA therapies using a claims-based algorithm in RA patients. Methods An electronic medical record (EMR) database from Zhujiang Hospital was utilized to estimate the cost-effectiveness of medication for RA patients, including IGU with MTX, biological DMARDs (bDMARDs) with MTX, and MTX alone for more than 6 months from 2014 to 2020. Patients who were deemed effective must meet all the following criteria according to the algorithm, high adherence; no bDMARDs or IGU switch or addition; no prescription of new csDMARDs; no increase in dose or frequency of index drug; no new use of chronic glucocorticoids or increase in glucocorticoid dose; and no more than one glucocorticoid injection. Average cost was calculated by summing total cost of effective treatment and dividing by number of patients achieving efficacy in each group. Results A total of 263 patients were included in the analysis. Based on a claims-based algorithm, the effective rate was 27.1 % (26/96) for IGU with MTX group, 11.2% (7/62) for bDMARDs with MTX group, and 13.3% (14/105) for MTX alone group, respectively. Average cost of effective treatment was $833.46 for IGU with MTX therapy, $2554.57 for bDMARDs with MTX therapy, and $171.48 for MTX alone (Table 1). Table 1. Effectiveness and Cost per Effectively Treated Patient with RA Criteria All patients (n=263) IGU with MTX group(n=96) bDMARDs with MTX group (n=62) MTX (n=105) Effectiveness:no. of patients (%) a 47(17.87%) 26 (27.1%) 7 (11.2/%) 14 (13.3%) Cost of all RA-related medication per effectively treated patient(SD) $892.75(911.57) $833.46 (252.67) $2554.5 (1273.13) $171.4 (110.33) Average cost of all RA medications postindex (excluding biologic DMARDs) per patient (SD) b $146.38(114.60) $148.81 (123.12) $86.90 (74.53) $171.4 (110.33) Average cost of only biologicDMARDs postindex per patient (SD) b $746.38(926.35) $684.27(188.67) $2468.67(1285.91) / a χ 2 showed significant difference in percentage effectiveness for the original algorithm (p&lt;0.05). b Medication cost was 2020 U.S. dollars. Conclusion IGU with MTX therapy was revealed to be both effective and modestly priced, which seemed to be a cost-effective strategy for RA therapy and warranted further cost-effectiveness investigation. References [1](2018) [2018 Chinese guideline for the diagnosis and treatment of rheumatoid arthritis]. Zhonghua Nei Ke Za Zhi 57 (4), 242-251. https://doi.org/10.3760/cma.j.issn.0578-1426.2018.04.004 [2]Hitchon, C. A., &amp; El-Gabalawy, H. S. (2011). The synovium in rheumatoid arthritis. The open rheumatology journal, 5, 107–114. https://doi.org/10.2174/1874312901105010107 [3]Smolen, J. S., Landewé, R., Bijlsma, J., Burmester, G. R., Dougados, M., Kerschbaumer, A., McInnes, I. B., Sepriano, A., van Vollenhoven, R. F., de Wit, M., Aletaha, D., Aringer, M., Askling, J., Balsa, A., Boers, M., den Broeder, A. A., Buch, M. H., Buttgereit, F., Caporali, R., Cardiel, M. H., … van der Heijde, D. (2020). EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Annals of the rheumatic diseases, 79(6), 685–699. https://doi.org/10.1136/annrheumdis-2019-216655 [4]Fraenkel, L., Bathon, J. M., England, B. R., St Clair, E. W., Arayssi, T., Carandang, K., Deane, K. D., Genovese, M., Huston, K. K., Kerr, G., Kremer, J., Nakamura, M. C., Russell, L. A., Singh, J. A., Smith, B. J., Sparks, J. A., Venkatachalam, S., Weinblatt, M. E., Al-Gibbawi, M., Baker, J. F., … Akl, E. A. (2021). 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis care &amp; research, 73(7), 924–939. https://doi.org/10.1002/acr.24596 Disclosure of Interests None declared